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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Embolism of the right middle cerebral artery regularly failed to induce clinical or electrical seizure activity during acute ischemia in primates. This negative correlation casts some doubt on the popular interpretation of seizures at the outset of clinical stroke as evidence of cerebral embolism.
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PMID:Laboratory note. EEG changes after acute cerebral embolism. 5 70

We evaluated 183 patients with brain ischemia for an embolic source, using transesophageal echocardiography with extensive imaging of the thoracic aorta. There were mobile, frond-like projections of aortic plaque in seven (4%) patients. The plaque originated on a wide base on the posterior aspect of the ascending aorta at its junction with the transverse arch in six patients, and on the aortic root in one. The acute event was a cerebral infarction in five patients, and a transient ischemic attack in two. This type of aortic plaque could be a previously underdiagnosed source of cerebral embolism that is now easily visualized by transesophageal echocardiography.
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PMID:Aortic plaque in patients with brain ischemia: diagnosis by transesophageal echocardiography. 164 Nov 58

The introduction of positron emission tomography (PET) to study the cerebral circulation and metabolism is for the present the last step in the evolution of a technology which started 40 years ago with the gas clearance method developed by Kety and Schmidt. To study cerebral blood flow and metabolism in humans the steady state 15O method (Frackowiak et al., 1980) is widely used in different PET centers. We have used this method in experimental animals. The principles of the method and the mathematical models which are at the basis of the calculation of cerebral blood flow (CBF) and oxygen metabolism (cerebral metabolic rate for oxygen, CMRO2 and oxygen extraction ratio, OER) are relatively simple but during its application in vivo several problems arise as described. The steady state method of Frackowiak et al. allowed in our experiments the accurate measurement of cerebral blood flow and oxygen metabolism in anesthetized dogs. We have investigated the effect of experimental cerebral embolism in different series of experiments. Two different models of cerebral ischemia were assessed. In the first model focal ischemia was produced by infusing Sephadex particles (mean diameter 40 microns) into the left common carotid artery; in the second model an autologous blood clot (100 microliters) was injected into the left internal carotid artery. With both procedures the ischemia was practically limited to the ipsilateral hemisphere. Moreover in the two models the effects of ischemia were very reproducible. This is probably due to the good standardization of the embolization procedures. The results clearly indicate a differential effect of microembolization with particles and blood clot embolization, illustrating the importance of the technique used to produce cerebral embolization in experimental animals. PET offers possibilities for diagnosis of cerebral ischemia. At variance with the classical techniques for studying cerebral blood flow PET also allows simultaneous assessment of cerebral metabolism and to differentiate between brain tissue which is irreversible damaged and tissue which can be potentially salvaged. Therefore PET also offers new possibilities in clinical and experimental research. The reproducible effects obtained with the blood clot model, the metabolic cerebral effects of which are similar to those of clinical stroke, will allow to study the effect of different therapeutic approaches for stroke such as thrombolysis and calcium entry blockade.
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PMID:[The use of radionuclides, specifically positron-emission tomography, in the determination of the blood circulation and metabolism of the brain. Application in experimental cerebral embolism]. 269 May 40

We found substantial alterations in reactions catalyzed by calcium/phospholipid-dependent and calcium/calmodulin-dependent protein kinases during CNS ischemia which suggested that phenothiazines, drugs capable of inhibiting these reactions, might reduce neurologic damage. To test this hypothesis, we used chlorpromazine and trifluoperazine. Both drugs reduced neurologic function deficits relative to controls in a rabbit multiple cerebral embolism model and a rabbit spinal cord ischemia model. Chlorpromazine was effective despite reduction of blood pressure, and trifluoperazine did not alter blood pressure. These findings suggest that phenothiazines may be useful for preserving neurologic function when administered shortly after the onset of CNS ischemia.
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PMID:Phenothiazines reduce ischemic damage to the central nervous system. 270 77

Moderate unilateral cerebral ischemia was produced by microembolism in 24 adult cats. Two million plastic microspheres with a diameter of 15 +/- 5 microns were injected into the left common carotid artery via the lingual artery. The physiological and metabolic responses to embolism were accessed by electrocorticography and by determining the cerebral energy state. Embolism caused an immediate slowing and voltage reduction of the ipsilateral electrocorticogram with a gradual recovery after 30 to 60 min. Some animals also had an immediate and short depression of the contralateral electrocorticogram. In spite of the market functional suppression, metabolites of the cerebral energy-producing metabolism in most of the animals changed only slightly. In the embolized hemisphere pyruvate increased from 0.06 to 0.10 mumol/g and lactate from 1.9 to 4.6 mumol/g within 5 min after embolization and remained at this level during the 4 h observation period. Phosphocreatine, adenosine triphosphate and the energy charge of the adenylate pool remained uncharged during this period. However, there was a slight increase of ATP in the non-embolized hemisphere during the early postembolic period. In two animals, the initial slowing of the electrocorticogram recurred and spread to the contralateral hemisphere, followed by bilateral flattening after a few hours. This delayed functional deterioration was accomplished by complete loss of energy-rich phosphates. These animals also had a progressive increase of cerebrospinal fluid (CSF) pressure and considerable brain swelling with cerebellar herniation after 4 h. It is concluded that unilateral cerebral embolism in the above concentration leads only to a slight increase of anerobic glycolysis without significant perturbation of the cerebral energy state, unless progressive brain swelling with cerebrellat herniation supervenes. This supports previous findings, that brain edema and not initial ischemia is the main pathogenetic factor for tissue damage in cerebral microembolism.
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PMID:The effect of mild microembolic injury on the energy metabolism of the cat brain. 615 90

The prerequisite in establishing the indication for coronary arteriography is low mortality and morbidity of the procedure. Mortality is about 1%, major complications are myocardial infarction (1.5 to 2%) and cerebral embolism (less than 1%). These low complication rates are generally achieved only in institutions which perform at least 400 procedures per year. Coronary arteriography is indicated in the following groups of patients: patients with angina pectoris aged below 45; patients over 45 with sudden worsening of angina, angina pectoris uncontrolled by medication (impaired quality of life) and cases where there is objective evidence of severe ischemia on exercise though angina is mild; recurrence of angina or positive stress ECG after myocardial infarction; following an episode of unstable angina; following resuscitation due to ventricular fibrillation; suspected Prinzmetal angina; postinfarction aneurysm with signs of heart failure; candidates for valve surgery aged over 45. Coronary arteriography is also performed to evaluate the result of bypass surgery, in patients with unclear diagnosis exposed to occupational hazards, and in acute myocardial infarction (thrombolysis, ventricular septal rupture, acute mitral regurgitation). The main indications for radioisotope studies (Tl-201 myocardial scintigraphy and radionuclide angiography during dynamic exercise) are detection and localization of ischemic zones and scars in patients with known coronary disease, and evaluation of the result of coronary artery bypass surgery. Less frequent indications are, today, atypical chest pain and uninterpretable ECG, and asymptomatic patients with abnormal stress ECG. 2-d echocardiography is the most widely used noninvasive technique for qualitative assessment of regional wall motion disorders at rest. 3800 coronary arteriographies are performed yearly in the public hospitals of Switzerland.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Indications for coronary angiography and other special studies]. 660 28

In this study, the middle cerebral artery (MCA) of adult male Sprague-Dawley rats was occluded by the modified Koizumi method to determine the temporal thresholds of reperfusion for the treatment of cerebral embolism. Regional cerebral blood flow (rCBF) and pathological findings were measured at 1 and 2 h of ischemia and after 24 h and 7 days of reperfusion following 1 or 2 h of ischemia. rCBF was decreased the most (less than 10% of control CBF) in the parietal cortex (Pcor) and the lateral caudoputamen (Lcp) at both 1 and 2 h of ischemia. There was no significant difference in rCBF in these areas between the 2 ischemic groups. The 2 h ischemia group clearly showed infarction in the area perfused by the middle cerebral artery (including the Pcor and Lcp) after 24 h and 7 days of reperfusion, while the 1 h ischemia group showed only slight infarction. These findings suggest that temporal thresholds of reperfusion in this model exist between 1 and 2 h of ischemia, and that rCBF levels during ischemia and the duration of ischemia are the most important factors in producing brain infarction.
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PMID:Temporal thresholds of reperfusion in the middle cerebral artery occlusion model in rats. 759 23

Effects of naftidrofuryl oxalate (naftidrofuryl) on neurotransmitter, acetylcholine, and amino acid content of brain regions following microsphere-induced cerebral embolism were examined to elucidate its possible therapeutic effects on ischemic brain. Rats received 900 microspheres (48 microns in diameter) via the right internal carotid artery, followed by ligation of the right common carotid artery; and histological and biochemical alterations were examined on the 3rd, 5th, and 28th days after embolism. The embolism induced increases in triphenyltetrazolium chloride- (TTC)-unstained areas and decreases in acetylcholine, glutamate, aspartate, and gamma-aminobutyric acid (GABA) contents in the cerebral cortex, striatum, and hippocampus of the right hemisphere, suggesting that microsphere embolism causes severe damage to these brain regions. Hematoxylin-eosin staining of the right cortical sections after embolism showed degeneration and necrosis of nerve cells with chromatolytic nuclei and eosinophilic cytoplasm. Changes in neurotransmitters of the left hemisphere were relatively small. Treatment with naftidrofuryl of the embolized rats with stroke-like symptoms took place from postoperative day 1 to 28. Treatment resulted in a reduction in TTC-unstained areas, less morphological damage to cerebral cortex on the 3rd and 5th days, and an appreciable restoration of acetylcholine content of three brain regions of the right hemisphere throughout the experiment, but restoration of neurotransmitter amino acids was observed to a smaller degree. The results suggest that naftidrofuryl is capable of preventing the development of ischemia-induced, sustained damage to brain regions vulnerable to oxygen deficiency, particularly by improving impaired acetylcholine metabolism.
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PMID:Effects of naftidrofuryl oxalate on microsphere-induced changes in acetylcholine and amino acid content of rat brain regions. 792 97

291 patients were subjected to carotid endarterectomy from January 1985 to June 1992 in two Australian medical institutions. Of the 291 patients, perioperative stroke occurred in 22 (6.3%) after 347 operations (moderate 17 and severe 5). The 22 patients were studied with Doppler scan, angiography, reexploration and CT. Reexploration showed that 12 of 14 patients had thrombosis in the internal carotid artery at operation. The etiological factors for perioperative strokes included thrombosis at the operative sites in 14 patients (64%), cerebral embolism after operation in 4, clamping ischemia in 2, intracerebral hemorrhage in 1 and unknown cause in 1. Six patients (27%) recovered completely in 4 weeks, 10 (45%) had mild residual neurological deficits, 5 (23%) had moderate neurological deficits and 1 died 3 days after operation. Only 6 patients had permanent neurological deficits (6/347, 17%).
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PMID:Perioperative stroke after carotid endarterectomy. Etiological risk factors and management. 795 88

To clarify the indications for local fibrinolytic therapy for acute cerebral embolism, correlation among initial regional cerebral blood flow (rCBF) abnormalities, recanalization timing, and computed tomographic scan (CT) findings two days later were evaluated in 17 cases. All cases included had embolic occlusion of middle cerebral or internal carotid arteries which showed no abnormal findings on initial CT corresponding to the acute events but did show abnormal CBF reduction on initial single photon emission computed tomography (SPECT). Relative rCBF was evaluated as the percentage radioisotope counts in the region of interest (ROI) of the affected side against the corresponding ROI in the unaffected contralateral side. Within 6 hours from onset, there was a tendency towards reversed time dependent tolerance of cortical infarction with residual relative rCBF. Hemorrhagic transformation was observed in one case whose relative rCBF was 35% or less. In 10 patients whose occluded arteries were not recanalized within 6 hours, cortical areas with residual relative rCBF of 70% or more did not develop infarction. In conclusions, a pre-therapeutic rCBF study using SPECT is considered to be mandatory: cases with moderate ischemia involving the cortex with residual relative rCBF of between 35% and 70% may be good candidates for local fibrinolytic therapy.
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PMID:Evaluation of regional cerebral blood flow using single photon emission tomography for the selection of patients for local fibrinolytic therapy of acute cerebral embolism. 900 85


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